By Milind Desai, Christine Jellis, Teerapat Yingchoncharoen
Valvular center medication revolves round the have to safely determine destinations of pathological buildings and/or the interventional instruments had to deal with that pathology. The imaging of the valves is constructing at a major velocity and the clinician has to be conscious of the benefits of every one modality and the way it compares to the others to be had. there's a want for a realistic, medical atlas designed to paintings the reader via instances and assessing the ultimate offerings on hand to physicians. This atlas will signify the complete multimodality imaging judgements wanted while assessing mitral valvular issues. inside this atlas the authors could be offering a entire pictorial evaluation of the hugely advanced pathology/treatment thoughts and administration during this diversified staff of sufferers with assorted mitral valvular pathologies. Imaging modalities circulation quick representing problem to practitioners. This atlas will let them to profit the alternatives on hand and be good versed in thoughts. it's going to consequently be crucial analyzing for all cardiac imagers, surgeons, interventionalists, anesthetists and trainees in those disciplines.
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Additional resources for An Atlas of Mitral Valve Imaging
Calciﬁc Mitral Stenosis A 55-year-old man with end-stage renal failure secondary to Alport’s disease who is undergoing thrice-weekly hemodialysis reports increasing breathlessness with minimal exertion and palpitations. He was noted to have a murmur on auscultation (Figs. 14). 7 3D reconstruction of the mitral valve in short axis, demonstrating heavy leaflet and annular calcification, which restricts leaflet opening Fig. 1 Learning Points Mitral annular calcification (MAC) occurs when calcium is deposited in the region between the posterior left ventricular wall and the posterior mitral leaflet .
5 Classification of Mitral Regurgitation Mitral regurgitation is typically stratified as mild, moderate, or severe using the spectral and color Doppler methods illustrated above. Further classification includes assessment for reversal of pulmonary venous flow (via PW Doppler at the ostium of a pulmonary vein as it enters the left atrium) and assessment of LV size, ejection fraction, and contractile reserve. Once severity is determined, classification of the cause of valve dysfunction is then typically performed visually from 2D images according to a standardized format.
The E-F slope can be affected by other factors including cycle length, valvular calcification, and reduced left ventricular compliance. Because of the one- dimensional nature of M-mode imaging, a falsely normal E-F slope may be recorded if beam alignment is not maintained at the leaflet tips. M-mode imaging is also valuable for detection of systolic anterior motion (SAM) of the anterior mitral valve leaflet typically seen in hypertrophic obstructive cardiomyopathy (HOCM). In HOCM, a Venturi effect is created within the left ventricular outflow tract (LVOT), and the mitral valve apparatus is sucked into the LVOT during systole.
An Atlas of Mitral Valve Imaging by Milind Desai, Christine Jellis, Teerapat Yingchoncharoen